School of Nursing, University of North Carolina at Chapel Hill, United states.
Assistant Professor, School of Nursing, University of North Carolina at Chapel Hill, United States.
Int J Nurs Stud. 2019 Oct;98:94-106. doi: 10.1016/j.ijnurstu.2019.06.010. Epub 2019 Jun 28.
Pain management after total knee arthroplasty and total hip arthroplasty is pivotal, as it determines the outcome of the recovery process after surgery. Ineffective pain control results in many postoperative complications and hinders successful recovery. In recent years, the transition from opioids to a multimodal pain management approach after total knee and total hip arthroplasty has increasingly become an alternative. This is due to the multitude of adverse effects associated with opioids. As a result, the use of non-opioid interventions such as acetaminophen, nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, gabapentinoids, and ketamine, and techniques such as peripheral nerve block and local infiltration analgesia have become more favorable.
This paper aims to summarize literature around the effectiveness of non-opioid interventions as part of a multimodal pain management after total knee and total hip arthroplasty.
A literature review was conducted to provide evidence-based information with respect to pain management during the postoperative period in order to enhance the pain recovery process. The literature chosen was extracted through the electronic databases PubMed, CINAHL, and Embase. Twenty-seven eligible articles were identified that met the inclusion and exclusion criteria.
Literary evidence shows that non-opioid interventions such as acetaminophen, nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, gabapentinoids, ketamine, peripheral nerve blocks, and local infiltration analgesia benefit patients after total knee and total hip arthroplasty for pain management. However, further quality research trials are necessary for more conclusive evidence-based information.
Selective literature supports the use of non-opioid interventions as part of a multimodal analgesics regimen for effective pain management after total knee and total hip arthroplasty.
全膝关节置换术和全髋关节置换术后的疼痛管理至关重要，因为它决定了手术后恢复过程的结果。疼痛控制效果不佳会导致许多术后并发症，并阻碍成功康复。近年来，全膝关节和全髋关节置换术后从阿片类药物向多模式疼痛管理方法的转变已成为一种替代方法。这是因为阿片类药物存在多种不良反应。因此，非甾体类抗炎药、环氧化酶-2 抑制剂、加巴喷丁类药物、氯胺酮等非阿片类药物干预措施以及外周神经阻滞和局部浸润镇痛等技术的使用变得更加有利。
本文旨在总结非阿片类药物干预措施作为全膝关节和全髋关节置换术后多模式疼痛管理的一部分的有效性文献。
进行文献回顾，提供有关术后期间疼痛管理的循证信息，以增强疼痛恢复过程。通过电子数据库 PubMed、CINAHL 和 Embase 提取文献。确定了 27 篇符合纳入和排除标准的合格文章。
文献证据表明，非阿片类药物干预措施，如对乙酰氨基酚、非甾体抗炎药、环氧化酶-2 抑制剂、加巴喷丁类药物、氯胺酮、外周神经阻滞和局部浸润镇痛，可使全膝关节和全髋关节置换术后的患者受益于疼痛管理。然而，需要进一步进行高质量的研究试验，以获得更具结论性的基于证据的信息。
有选择性的文献支持将非阿片类药物干预措施作为多模式镇痛方案的一部分，用于全膝关节和全髋关节置换术后的有效疼痛管理。
